Facility Evaluation Report

Licensing Program Analyst (LPA's) K.Kaur and J. Leffall conducted a Pre-licensing Inspection on this date. LPA's met with Licensee Marietta Diaz and Administrator Taimi Lopez. A tour of the facility was conducted together. This is a change of ownership with 3 residents in care. The facility was observed to be at a comfortable temperature. No passageway obstructions or fire hazards were observed inside or outside. Common areas were properly furnished and well-lit throughout. Knives and sharps are locked in kitchen cabinet. LPAs observed broken/cracked tile in dining area that lifts when stepped on. Fire extinguisher observed in the kitchen with a service date of 12/4/2023. Medications are locked in cabinet hallway next to bedroom #3. Living room is equipped with adequate sofas and recliners. Cleaning and Chemical supplies observed locked in laundry room next to the washing machine and under kitchen sink. Additional cracked tile observed in hallway next to laundry room. Resident’s bedrooms were observed to be adequately furnished with bed, dresser, chair and adequate lighting. Per Fire Department, Master bedroom is the only bedroom approved for non-ambulatory. Mattresses and linen were in good condition. Extra linen and towels are available in the hallway closet. Carbon monoxide and smoke alarm detectors installed and operational. Grab bars installed in shower and by toilet, non-skid mats in place, hand soap and paper towels available for use. Trash cans with tight fitting lids are in place. Water temperature measured at 109 degrees F. All signs are posted. Adequate outside space for rest and recreational under a covered patio with sufficient seating. Gate is self-closing and self-latching. LPAs reviewed resident files and observed 2 out of 3 residents were above 60 years old. LPAs observed licensee to submit Exception request since more than 50% of residents are above age 60. LPAs advised Licensee both ARF and RCFE guidelines will need to be followed and provided Licensee regulations 85068.4 and 80069.2.

The following issues will need to be corrected prior to pre-licensing visit and Licensure of facility:

2. Exception request needs to be submitted to CCLD regarding Acceptance and Retention Limitations 85068.4

An exit interview was conducted with Licensee/Administrator. Report signed on-site by Licensee a copy of this report will be emailed due to technical difficulties.